Thread for the production of knotted ligatures, more especially for surgical purposes and particularly for the ligaturing of blood vessels during operations



Oct. 21, 19 59 KAMMER 2,910,066 THREAD FOR THE PRODUCTIO F KNOTTEDLIGATURES, MORE ESPECIALLY FOR SURGICAL PURPOSES AND PARTICULARLY F THELIGATURING OF BLOOD VESSELS DURING OPER ONS Filed Jan. 5. 1954 3Sheets-Sheet 1 M AW IIIIIIIIIIIIIIII' A l f/g. 8

Oct. 27, 1959 THREAD FOR THE PRODUCTION OF KNOTTED LIGATURES, MOREESPECIALLY FOR SURGICAL PURPOSES AND PARTICULARLY FOR THE LIGATURING OFBLOOD VESSELS DURING OPERATIONS Filed Jan. 5

K. KAMMER 2,910,066

3 Sheets-Sheet 2 Oct. 27, 1959 K KAMMER 2,910,066

THREAD FOR THE PRODUCTION Oi KNOTTED LIGATURES, MORE ESPECIALLY FORSURGICAL PURPOSES AND PARTICULARLY FOR THE LIGATURING OF BLOOD VESSELSDURING OPERATIONS Filed Jan. 5. 1954 3 Sheets-Sheet 3 United StatesPatent THREAD FOR THE PRODUCTION OF KNOTTED LIGATURES, MORE ESPECIALLYFOR SURGI- CAL PURPOSES AND PARTICULARLY FOR THE LIGATURING OF BLOODVESSELS DURING OP- ERATIONS Karl Kammer, Lahr, Baden, GermanyApplication January 5, 1954, Serial No. 402,360

Claims priority, application Germany July 3, 1953 9 Claims. (Cl.128-326) The present invention relates to a ligature carrier, and moreparticularly to a ligature carrier which carries a pre-looped ligatureready for transfer to a surgical instrument.

It is one object of the present inventionto provide a ligature carrierto which a pre-looped ligature is detachably attached, so that it can beimmediately transferred to a suitable ligaturing instrument capable oftightening the pre-looped ligature into a double knot on a blood vessel.Another object of the present invention is a ligature carrier includinga plate which may remain directly on the surgical instrument as aprotection for the ligature during the tying operation.

Another object of the present invention is a readylooped ligaturearrangement including a supporting plate and a ligature, which can beprepared in non-sterilized condition, and then sterilized in largenumbers while the ligature remains on the supporting plate.

With these objects in view, the present invention mainly consists in aligature carrier which comprises, in combination, support plate meansfor supporting a ligature to be tied into a knot and having at least onefirst boss portion surrounded by a first loop portion of a ligature, andat least one second boss portion surrounded by another loop portion ofthe ligature, the respective loopportions constituting the inner andouter loops of a ligature knot tied on a blood vessel so that when theligature is transferred to a surgical instrument, a double knot iseasily tied by the surgical instrument on the blood vessel.

The novel features which are considered as characteristic for theinvention are set forth in particular in the appended claims. Theinvention itself, however, both as to its construction and its method ofoperation, together with additional objects and advantages thereof, willbe best understood from the following description of specificembodiments when read in connection with the accompanying drawings, inwhich:

Figure 1 is a plan view illustrating a ligature carrier according to thepresent invention;

Figure 2 is a sectional view of the ligature carrier shown in Figure 1taken on line 11-41;

Figure 3 is a bottom view of the ligature carrier shown in Figure 1;

Figure 4 is a fragmentary plan view of a part of the ligature carrier;

Figure 5 is a plan view of another part of the ligature carrier;

Figure 6 is an exploded side view showing the parts of Figures 4 and 5;

Figure 7 is a longitudinal section of a magazine for the ligaturecarriers;

Figure 8 is a horizontal sectional view taken on line VIIIY-VIII ofFigure 7;

Figure 9 is a longitudinal sectional view of a modified embodiment of amagazine;

Figure 10 is a cross sectional view taken on line X--X of Figure 9;

Figure 11 is a longitudinal sectional view illustrating a modifiedmagazine for ligature carriers including an ejector member;

Figure 12 is a cross sectional view taken on line XII XII of Figure 11;

Figure 13 is a plan view of a ligature carrier according to the modifiedembodiment of the present invention;

Figure 14 is a view partly in section on line XlV- XIV in Figure 13 andshowing a surgical instrument for tying blood vessels;

Figure 15 is a plan view of the arrangement shown in Figure 14 with apart of the ligature carrier removed; and

Figure 16 is a side elevation showing the ligature carrier in thecondition of Figure 15, and including the surgical instrument.

Referring now to the drawings, and more particularly to Figures 1 to 6,a ligature 1 consisting of catgut, for example, is attached inpre-looped condition to a supporting plate means and wound in two loops2 and 3 so that a double knot is produced when the loops 2 and 3 arelater on tightened by a surgical instrument. The crossing points 5 and 6of the two loops are disposed above each other. The supporting platemeans may consist of metal, or artificial transparent material, and hassuch a size and shape as to correspond to the shape of correspondingportions of a ligaturing instrument, as is, for example, described inthe co-pending applications Serial No. 347,336, now abandoned and SerialNo. 402,359.

Boss portions 7, 8 and 9 project above the surface of support plate 4and are part of another plate 10. The center boss portion 7 has anopening passing therethrough and is consequently tubular, whereas theother boss portions 8 and 9 are short solid pins. Boss portions 7, 8 and9 project through openings 7 8' and 9 in plate 4.

The ligature 1 is wound about the boss portions 7, 8 and 9 in front ofplate 4. The ends 11 and 12 of the ligature are guided around the edge13 of plate '4 and placed under the surface 14 of plate 10 so that theyare attached to the ligature carrier 4, 10 by the clamping pressurebetween the plates 4 and 10. After a ligature has been wound on theligature carrier as above described, it can be sterilized together withthe carrier, and the supporting plate 10 and 7 can be discarded as wasteafter the ligature has been transferred to a surgical instrument.

Ready-looped ligature carriers are stored in a magazine of the typeshown in Figures 7 to 12. The magazine has a base 15 with a tubularguide wall 16. A container 17 containing a stack of ligature carriers isinserted into the tubular guide wall 16 so that its open end is closed.Slots 18 and 19 are provided in the container 17 and in the guide wall16 through which the ligature carrier plates can be removed by pincers,while successive ligature carriers move down to the base plate 15. Aguide rib 2.0 is provided in container 17 for holding the carrier plates4 in proper position, and engages a notch in the carrier plate 4. Thefree ends of the ligature are located on both sides of'the guide rib 20.

in the modified magazine shown in Figures 9 and 10, instead of the guiderib 20, a guide rod 21 is provided which passes through the centeropening 7 and 7' of the ligature carriers. Theend of the guide rod 21 isspaced from the base plate to permit removal of ligature carriersthrough slots 18 and 19, which can be aligned by turning container 17through out of the position shown in Figure 9 in which the magazine isclosed. In the modified embodiment of Figure 11, the foremost carrierplate is ejected through slots 18 by operation of a pusher member 22which is normally retracted by a spring 23.

Figures 13 to 16 show a modified embodiment of the ligature carrier. Aflat carrier plate 24 has wound thereon a ligature which. forms twoloops which are held in.

position by a cover plate 25. Aligned holes 26 are provided in thecarrier plate24 and in the cover plate. 25, and

additional aligned holes 29 are provided in plates 24 and 25. Carrierplate 24 has a flap 31 provided with notches and tongues 32 into whichthe free ends of the ligature 1 are clamped, and which constitutesecuring means for holding the ligature. The cover plate is perforatedalong lines 33 and can be broken along these lines when force is appliedto the two flaps 34 and 35 thereon. V

The ligature carrier shown in Figure 13 is placed on a surgicalljgaturing instrument 27 which includes a pair of pins 30, forceps 28for clamping a blood vessel, and buttons 37 for tightening a ligature.The ligature carrier is placed on the instrument with the forceps 28passing through holes 26, and the pins located in the holes 29, coverplate 25 facing the instrument, and plate 24 facing outward. The freeends 36 of the ligature 1 are connected withbuttons 37 which werepreviously ughened, and after loosening of buttons 37 the free ends 36of the ligature are tightened in the direction of the arrows in Figure16 whereby the prepared loops of the ligature are detached from theplates 24 and 25 and lie around the forceps 28 and pins 30. Carrierplate 24 can now be removed, while cover plate 25 is broken by bendingthe same with the aid of flaps 34 and 35. In this manner the carrier isdiscarded, while the pre-looped ligature is now transferred to thesurgical instrument.

In the embodiment of Figures 1 to 6, the ligature is transferred to thesurgical instrument by placing the forceps in the opening 7, whereuponthree ejector members of the instrument are actuated to act on bossportions 7, 8 and 9 to push plate 10 with bosses 7, 8 and 9 out of plate4 so that the ready-looped ligature is located on the instrument. Inthis embodiment the plate 4 remains temporarily on the applicance duringthe tying of the blood vessel, and may be retained by resilient meansacting on the cutout portions a and b.

It will be understood that each of the elementsdescribed above, or twoor more together, may also find a useful application in other types ofligature carriers differing from the types described above.

The invention is not intended to be limited to the details shown, sincevarious modifications and structural changes may be made withoutdeparting in any way from the spirit of the present invention.

What is claimed as new and desired to be .secured by Letters Patent is:

What I claim is:

l. A ligature carrier comprising, in combination, support plate meansfor supporting a ligature or the like to be tied into a knot, saidsupport plate means having at least one first boss portion adapted to besurrounded by a portion of a ligature carried by said support meanswhich constitutes the inner loop of a prospective ligature knot and atleast one second boss portion adapted to be surrounded by anotherportion of the ligature which constitutes the outer loop of theprospective ligature knot so that said ligature is adapted to betransferred to a surgical instrument; and securing means for securingthe free end portions of the ligature to said support plate means.

2. A ligature carrier comprising, in combination, support plate meansfor supporting a ligature or the like to be tied in a knot, said supportplate means being formed with opening means therethrough and a firstannular boss portion surrounding said opening means and adapted to besurroundedby a portion of a ligature carried by said support plate meanswhich constitutes the inner loop of a prospective ligature knot, saidsupport plate means being also formed with at least one second bossportion adapted to be surrounded by another portion of the ligaturewhich constitutes the outer loop of the prospective ligature knot; andsecuring-means for securing the free end portions of the ligature tosaid support plate'i'neans.

3. A ready-looped ligature arrangement comprising, in combination,discardable ligature carrier means having a first portion and at leastone-seco'ndportionya ligature carried by said ligature carrier means andadapted to be sterilized together with the same, said ligature having afirst portion constituting the inner loop of a prospective ligature knotsurrounding said first portion and a second portion constituting theouter loop of the prospective ligatnre knot surrounding said secondportion so that said ligature is adapted to be transferred to a surgicalinstrumen't; and securing means for securing the free ends of saidligature to said ligature carrier means.

4. A ligature carrier for supporting a ligature or the like to be tiedinto a knot comprising, in combination, first plate means formed withfirst opening means and with at least one second opening meanstherethrough; second plate means having a first boss portion and atleast one second boss portion and located adjacent said first platemeans and said first boss portion projecting through said first openingmeans and said second boss portion projecting through said secondopening means, said first boss portion being adapted to be surrounded bya portion of a ligature carried by the ligature carrier whichconstitutes the inner loop of a prospective ligature knot and saidsecond boss portion being adapted to be surrounded by another portion ofthe ligature which constitutes the outer loop of the prospectiveligature knot whereby the ligature carrier is adapted to carry areadylooped ligature; and securing means for securing the free endportions of the ligature to said plate means.

5. A ligature carrier for supporting a ligature or the like to be tiedinto a knot comprising, in combination, first plate means formed withfirst opening means and with at least one second opening meanstherethrough; second plate means formed with third opening meanstherethrough and a first annular boss portion surrounding said thirdopening means, said second plate means being also formed with at leastone second boss portion, said second plate means being located adjacentsaid first plate means so that said first and third opening means are inregistration with each other, said first annular boss portion projectingthrough said first opening means and said second boss portion projectingthrough said second opening means, said first annular boss portion beingadapted to be surrounded by a portion of a ligature carried by theligature carrier which constitutes the inner loop of a prospectiveligature knot and said second boss portion being adapted to besurrounded by another portion of the ligature which constitutes theouter loop of the prospective ligature knct whereby the ligature carrieris adapted to carry a ready-looped ligaturei and securing means forsecuring the free end portions of the ligature to said plate means.

6. A ligature carrier comprising, in combination, sup-- port plate meansfor supporting a ligature or the like to be tied into a knot, saidsupport plate means being formed with opening means therethrough and afirst annular boss portion surrounding said opening means and adapted tobe surrounded by a portion of a ligature carried by said support platemeans which constitutes the inner loop of a prospective ligature knot,said support plate means being also formed with two second boss portionsadapted to be surrounded by another portion of the ligature whichconstitutes the outer loop of the prospective ligature knot; andsecuring means for securing the free end portions of the ligature tosaid support plate means.

7. A ready-looped ligature arrangement comprising, in combination,ligature carrier plate means having a first boss portion and at leastone second boss portion; and a ligature carried by said ligature carrierplate means and having a first portion constituting the inner loop of aprospective ligature knot surrounding said first boss portion and asecond portion constituting the outer loop of the prospective ligatureknot surrounding said second boss portion, said ligature carrier platemeans being adapted to be placed adjacent a receiving apparatus havingfirst and second receiving means for engaging said first and second bossportions, respectively, so that the ligature may be transferred theretoin 'sueh'a manner'that the inner loop of the prospective ligature knotsurrounds the first receiving means and the outer loop of theprospective ligature knot surrounds the second receiving means.

8. A ligature carrier for supporting a ligature or the like to be tiedinto a knot comprising, in combination, first plate means formed withfirst opening means and with at least one second opening meanstherethrough; and second plate means having a first boss portion and atleast one second boss portion and located adjacent said first platemeans and said first boss portion projecting through said first openingmeans and said second boss portion projecting through said secondopening means, said first boss portion being adapted to be surrounded bya portion of a ligature carried by the ligature carrier whichconstitutes the inner loop of a prospective ligature knot and saidsecond boss portion being adapted to be surrounded by another portion ofthe ligature which constitutes the outer loop of the prospectiveligature knot whereby the ligature carrier is adapted to carry areadylooped ligature, that first and second plate means in saidassembled position being adapted to be placed adjacent a receivingapparatus having first and second receiving means for engaging saidfirst and second boss portions, respectively, while the same projectthrough said first and second opening means, respectively, the first andsecond receiving means also projecting through said first and secondopening means, respectively, so that the readylooped ligature may betransferred thereto in such a manner that the inner loop of theprospective ligature knot surrounds the first receiving means and theouter loop of the prospective ligature knot surrounds the secondreceiving means by movement of said second plate means relative to saidfirst plate means and to the receiving apparatus in a direction awayfrom said first plate means and toward the first and second receivingmeans.

9. A ligature carrier for supporting a ligature or the like to be tiedinto a knot comprising, in combination, first plate means formed withfirst opening means and with at least one second opening meanstherethrough; and second plate means formed with third opening meanstherethrough and a first annular boss portion surrounding said thirdopening means, said second plate means being also formed with at leastone second boss portion, said second plate means being located adjacentsaid first plate means so that said first and third opening means are inregistration with each other, said first annular boss portion projectingthrough said first opening means and said second boss portion projectingthrough said second opening means, said first annular boss portion beingadapted to be surrounded by a portion of a ligature carried by theligature carrier which constitutes the inner loop of a prospectiveligature knot and said second boss portion being adapted to besurrounded by another portion of the ligature which constitutes theouter loop of the prospective ligature knot whereby the ligature carrieris adapted to carry a ready-looped ligature, said first and second platemeans in said assembled position being adapted to be placed adjacent areceiving apparatus hav ing first receiving means for projecting throughsaid first annular boss portion and consequently through said first andthird opening means, the receiving apparatus also having secondreceiving means for engaging said second boss portion While the sameprojects through said second opening means, the second receiving meansalso projecting through said second opening means so that thereadylooped ligature may be transferred thereto in such a manner thatthe inner loop of the prospective ligature knot surrounds the firstreceiving means and the outer loop of the prospective ligature knotsurrounds the second receiving means by movement of said second platemeans relative to said first plate means and to the receiving apparatusin a direction away from said first plate means and toward the first andsecond receiving means.

References Cited in the file of this patent UNITED STATES PATENTS701,501 Parker June 3, 1902 1,234,051 Lukens July 17, 1917 1,625,602Gould et al. Apr. 19, 1927 2,215,850 Holdeman Sept. 24-, 1940 2,297,847Wilckens et al. Oct. 6, 1942 2,352,113 Muros June 20, 1944 2,433,956Miller Jan. 6, 1948 2,677,510 Osborne May 4, 1954 FOREIGN PATENTS453,256 Germany Jan. 7, 1929

